In April 2011, the Center for Medicare Advocacy celebrates 25 years of advocating for, and on behalf of, older people and people with disabilities who rely on Medicare. We started as a small organization in Connecticut, added a Data Unit in Maine, a policy office in Washington, D.C., and satellite offices in Tucson, Arizona, Massachusetts, and New Jersey. From its inception, the advocacy goal of the Center has been to ensure access to fair, affordable, quality health care.

The primary focus of the Center has been to help individual Medicare beneficiaries obtain the Medicare-covered services and benefits to which they are entitled, through direct client assistance with appeals of denied Medicare claims and systemic advocacy through litigation and policy work.

Recent proposed changes have threatened Medicare in ways it has never been threatened before. The most drastic is the Budget reconciliation proposal of Rep. Paul Ryan, which would turn Medicare into a voucher program, placing the burden of healthcare costs more squarely on the shoulders of older and disabled Americans than at any time since 1965, before Medicare's inception. Ryan's proposal could lead us back to the days when only 50% of older Americans had adequate health coverage.

Hopeful Signs

President Obama, in his remarks this week in response to the Budget Reconciliation proposal, expressed his support for changes that would actually strengthen Medicare. The White House has drawn a line, refusing to pretend the elimination of Medicare and Medicaid are necessary to protect America's future, and instead called for real, shared responsibility, and the continuation of efforts to provide affordable health care for all.

The President's framework for fiscal responsibility recognizes the importance of Medicare and Medicaid to Americans, and protects the integrity of Medicare and Medicaid by building upon the progress made in the Affordable Care Act to cut overall health care costs. His proposals strengthen both programs while achieving savings by addressing Medicare physician payment reforms; reducing overpayments; improving care for those who are eligible for both Medicare and Medicaid; and focusing on wasteful spending and cost growth.

The President was explicit about his vision for Medicare and Medicaid when he said:

"…let me be absolutely clear: I will preserve these health care programs as a promise we make to each other in this society. I will not allow Medicare to become a voucher program that leaves seniors at the mercy of the insurance industry, with a shrinking benefit to pay for rising costs. I will not tell families with children who have disabilities that they have to fend for themselves. We will reform these programs, but we will not abandon the fundamental commitment this country has kept for generations."

The Center for Medicare Advocacy applauds the President for his work to preserve Medicare, Medicaid and the well-being of American families who are already struggling in today's economy. We thank the President for recognizing that fiscal responsibility for the federal government does not mean eliminating programs like Medicare and Medicaid that work to provide access to health care for vulnerable populations. Nor does it mean saving federal dollars by shifting costs to states, families and taxpayers.

Looking Forward

The Center's work has changed over the past 25 years. We have learned about new benefits as Medicare coverage has expanded, and we have, by necessity, expanded our policy work and litigation. Challenges to fair, adequate and affordable Medicare and other health coverage will continue, as we have seen in recent weeks. Proposals to dismantle Medicare and to do away with its guaranteed benefit structure are under serious consideration, as are proposals to do away with Medicaid and the expansion of health insurance to those who are uninsured. We intend to fight these and other proposals, while continuing to ensure that Medicare beneficiaries have a voice in the debate collectively, and have representation as individuals.

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